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This is VAERS ID 1183110

History of Changes from the VAERS Wayback Machine

First Appeared on 4/16/2021

VAERS ID: 1183110
VAERS Form:2
Age:33.0
Sex:Male
Location:Colorado
Vaccinated:2021-04-05
Onset:2021-04-07
Submitted:0000-00-00
Entered:2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 RA / IM

Administered by: Other      Purchased by: ??
Symptoms: Chest pain, Electrocardiogram, Fatigue, Hyperhidrosis, Pain, Pericarditis, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Adderall, vitamin, vitamin b, zyrtec
Current Illness: None
Preexisting Conditions: Adhd, mild asthma
Allergies: General allergies
Diagnostic Lab Data: Ekg
CDC 'Split Type':

Write-up: April 5th sore arm 11:30pm fever of 100.2 on tylenol. Took advil at 3am. Still had fever and sweating. April 6th felt tired and achy. The night of April 7th at 1am had severe chest pain, felt like heart attack. Went to urgent care at 5:55pm April 7th. Had ekg done and was diagnosed with pericarditis. Was treated with ib prophen 800mg 3x a day for one week. Follow up appointment with primary care April 15th.


Changed on 5/7/2021

VAERS ID: 1183110 Before After
VAERS Form:2
Age:33.0
Sex:Male
Location:Colorado
Vaccinated:2021-04-05
Onset:2021-04-07
Submitted:0000-00-00
Entered:2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 RA / IM

Administered by: Other      Purchased by: ??
Symptoms: Chest pain, Electrocardiogram, Fatigue, Hyperhidrosis, Pain, Pericarditis, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Adderall, vitamin, vitamin b, zyrtec
Current Illness: None
Preexisting Conditions: Adhd, mild asthma
Allergies: General allergies allergies
Diagnostic Lab Data: Ekg
CDC 'Split Type':

Write-up: April 5th sore arm 11:30pm fever of 100.2 on tylenol. Took advil at 3am. Still had fever and sweating. April 6th felt tired and achy. The night of April 7th at 1am had severe chest pain, felt like heart attack. Went to urgent care at 5:55pm April 7th. Had ekg done and was diagnosed with pericarditis. Was treated with ib prophen 800mg 3x a day for one week. Follow up appointment with primary care April 15th.


Changed on 5/14/2021

VAERS ID: 1183110 Before After
VAERS Form:2
Age:33.0
Sex:Male
Location:Colorado
Vaccinated:2021-04-05
Onset:2021-04-07
Submitted:0000-00-00
Entered:2021-04-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808980 / 1 RA / IM

Administered by: Other      Purchased by: ??
Symptoms: Chest pain, Electrocardiogram, Fatigue, Hyperhidrosis, Pain, Pericarditis, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Adderall, vitamin, vitamin b, zyrtec
Current Illness: None
Preexisting Conditions: Adhd, mild asthma
Allergies: General allergies allergies
Diagnostic Lab Data: Ekg
CDC 'Split Type':

Write-up: April 5th sore arm 11:30pm fever of 100.2 on tylenol. Took advil at 3am. Still had fever and sweating. April 6th felt tired and achy. The night of April 7th at 1am had severe chest pain, felt like heart attack. Went to urgent care at 5:55pm April 7th. Had ekg done and was diagnosed with pericarditis. Was treated with ib prophen 800mg 3x a day for one week. Follow up appointment with primary care April 15th.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1183110&WAYBACKHISTORY=ON

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